P.SUDHAKAR vs GOWRI GOPAL HOSPITAL

THE complainant''s son Master P. Ujwal, aged 14 years, complained of stomach pain at about 7.00 p.m. on 19.9.1997 and he was rushed to the second opposite party Surgeon, hereinafter called ''the Doctor'' whose clinic is opposite to Government General Hospital, Kurnool. He advised scanning of stomach. On seeing the report, he advised for immediate surgery diagnosing it as ''Acute Appendicits''. He also gave a letter dated 19.9.1997 fixing the operation on 20.9.1997 addressed to the A.R.M.O. of the first opposite party hospital. THE doctor advised the complainant to be at the first opposite party hospital by 6.30 a.m. on 20.9.1997, and performed the surgery at 8.45 a.m. He gave a prescription for certain medicines which were accordingly brought by the complainant. After surgery the boy was shifted to Room No. 26. THE doctor Y. Krishna Mohan and Sister Chinnamma advised him to bring the medicines as per the prescription given to him. He brought the medicines from the Pharmacy of the G.G. Hospital and kept them in Room No. 26. THE staff nurse Vijaya Susheela came to the room after 9.30 p.m. and injected one ampule of ''Fancuran'' from the medicines in the room to the boy intravenously. Within 2 or 3 seconds he expressed that something is happening to him and his legs and hands were shaking. Immediately the eyes of the boy became half-closed and his lips turned blue. THE staff nurse Vijaya Susheela had neither seen the case sheet nor consulted Dr. Y. Krishna Mohan, who was present in the hospital before giving the injection. THEreafter, Dr. Krishna Mohan after contacting other doctors in the hospital took the boy to Room No. 8 of I.C.C. Unit in the third floor. THE boy as kept under Ventilator. Apart from the second opposite party doctor other doctors, namely Dr. Surya Rao, Dr. Kailas Nath Reddy, Dr. Vasanth Kumar, Dr. H. Radha Krishna, Dr. N. Rama Chandra Rao, Dr. Anthony Reddy and Dr. Khadri visited the boy. Finally Dr. Vasanth Kumar came out of the room and declared that the boy has gone into ''Hypoxia''. THEreafter, the opposite parties tried to revive the patient, but they failed and finally they had given the death report on 25.9.1997.

WHILE the treatment was going on, the complainant wanted to shift the boy to Apollo Hospital, Hyderabad. For that purpose the Doctor and Dr. H. Radha Krishna gave letters to him addressed to Dr. Krishna Reddy, Professor of Neurology, Osmaia Medical College/Osmania General Hospital, Hyderabad stating that the boy was given Pancuronium Bromide (Fancuran) through intra-venous (I.V.) by mistake. The complainant, therefore, states that giving ''Fancuran'' injection is an act of sheer negligence which alone resulted in the death of the patient. He, therefore, claims a compensation of Rs. 20 lakhs. The second opposite party filed written version which is adopted by the opposite parties 1, 4 and 5, wherein it is stated that the complainant does not disclose how ''Fancuran'' entered into the room and who brought it which was not prescribed. In his anxiety the complainant had taken Bill No. 11159 in computer. The said bill in Sree Janapriya Hospitals Pvt. Ltd., is altogether a different one prescribed by Dr. P.N. Rao, Gastro-enterologist from Hyderabad. On 22.9.1997 at about 10.00 a.m. Mr. Sampath, husband of Dr. Geetha Lakshmi approached Dr. H. Radhakrishna and expressed his intention as well as the intention of the other attendants of the patient that they would like to have a second opinion from an expert in Hyderabad and requested for a letter of introduction. The doctor guessed and suspected some injection or some medicine that caused respiratory trouble affecting the brain. Mr. Sampath brought this letter to the second opposite party and requested him to give one more letter. At that time Mr. Sampath stated that the night duty sister gave ''Fancuran'' injection to the patient which caused the trouble. Hence he gave a letter on 22.9.1997 but it was not a statement on any personal knowledge but based on the information conveyed by Mr. Sampath.

At no time the complainant had found fault with the opposite parties. Though the boy died on 25.9.1997 at 4.00 a.m. the complainant did not give any complaint to the police or to the hospital authorities. He took away the dead body to his native place and buried it, but gave police complaint on 4.10.1997 and filed this complaint on 4.3.1998. The case sheet shows that at 10.00. p.m. on 20.9.1997 injection ''Divon'' was given Intra-Mascular (I.M.). The same injection was given after operation at 10.00 a.m. There was no reaction. If it has given reaction when given at 10.00 p.m. it is a rare phenomenon in rarest of rare cases but there is no negligence of the doctor.

THE third opposite party denied having given ''Fancuran'' injection to the boy either at 9.45 p.m. or at 10.00 p.m. but she only gave injection ''Divon'' Intra-Muscular as per the prescription in the case sheet. The complainant filed the affidavit of Shri P.L. Subbaiah, father of complainant, Sri P. Ramakrishnaiah, Smt. P. Bhagyalakshmi apart from his affidavit in support of his case. He also filed Exs. A-1 to A13.

THE opposite parties filed the affidavits of (1) Dr. Y. Anthony Reddy, Executive Director and Supervising Doctor, and (2) Dr. A. Vasanth Kumar, Cardiologist working in first opposite party hospital, (3) Dr. Radha Krishna, Neurologist in Government General Hospital, Kurnool apart from the affidavit of second opposite party Dr. Y. Satya Narayana. THEy also filed Exs. B-1 to B-21. THE point for consideration is whether there is any deficiency in service on the part of the opposite parties, if so, to what extent ? There is no dispute that the complainant consulted the second opposite party when his son complained of stomach pain on 19.9.1997 who called for a stomach scanning. On perusal of the scan report Ex. A-1, he diagnosed the problem as ''Acute Appendicitis'' and advised immediate surgery. He gave Ex. A-2 letter addressed to A.R.M.O. of the first opposite party hospital stating that he is sending Master Ujwal for Appendectomy by 8.00 a.m. on 20.9.1997. He also requested him to admit and arrange and further asked him to inform Sister Chinnamma. Therefore, it is clear that the second opposite party alone fixed the hospital for surgery when the complainant approached the former. The operation went on uneventful which was conducted by the second opposite party at 8.45 a.m. Afterwards the boy was shifted to room No. 26 in the first floor and he was recovering. At that time Sister Chinnamma was there and she left after her duty hours at 9.30 p.m. Later Staff Nurse Vijaya Susheela came to the room and gave one ampule of ''Fancuran'' I.V. which proved fatal. Of course there is no denial of these facts except the administration of ''Fancuran'' injection to the boy intravenously. It is the case of the complainant that after the boy was brought to Room No. 26, he was told that the condition of the former was good. Thereafter Sister Chinnamma advised him to bring the medicines mentioned in Exs. A-8(a) and A-8(b). Accordingly he brought the medicines from the Pharmacy of G.G. Hospital and kept them in Room No. 26. He filed the relevant bills Exs. A-8 C1 and A-8 C2. In Ex. A-8 C2, mention of ''Fancuran'' injection is seen. The bill is dated 20.9.1997 issued by Sree Janapriya Hospitals Pvt. Ltd., a group of hospitals of which the first opposite party Gowri Gopal Hospital is one. But this bill is disputed by the opposite parties. No satisfactory basis is shown for such objection. Hence we have to take it that the said medicine was sold on that day to the complainant as the name of the patient as well as the name of the hospital were correctly mentioned in the bill. Be that as it may.

IT is the contention of the complainant that after 9.30 p.m. after Sister Chinnamma left the hospital, Staff Nurse Vijaya Susheela, the third opposite party assumed duty and she gave the injection ''Fancuran'' I.V. at about 9.45 p.m. Within seconds the boy expressed that something is happening to him by shaking his legs and hands followed by closing of the eyes and his lips turned blue. Thereafter, Dr. Krishna Mohan took him to room No. 8 of I.C.C. Unit in the third floor and gave him artificial breathing. He also informed to number of other doctors whose names are already referred to above. But the condition of the patient became critical and Dr. Vasanth Kumar who was in the team of the doctors attempted to revive the patient, came out and declared that the boy had gone into ''Hypoxia'' who later died on 25.9.1997 in the same hospital. The contention of the complainant is that all this happened due to careless administration of the injection ''Fancuran'' by the third opposite party, while the opposite parties maintained that only ''Divon'' I.M. was given and not ''Fancuran''. Now the question is whether ''Fancuran'' injection was given or not?

IN support of his assertion, the complainant relies on Ex. A-11 letter dated 22.9.1997 written by second opposite party. Ex. A-12 is another letter of Dr. Radhakrishna addressed to Dr. Krishna Reddy, Professor of Neuroglogy, OMC/OGH, Hyderabad. IN Ex. A-12 Dr. Radhakrishna mentioned that the boy was alright till evening on the date of operation for ''Appendectomy'' and he developed Cardio Respiratory Arrest at about 10.00 p.m. following an injection. Within 5-10 minutes he was discovered to be in Cardiac Respiratory Arrest. He was incubated and connected to Ventilator. Of course he mentioned the condition of the boy and the treatment given thereafter. In Ex. A-11 the second opposite party has clearly motioned that on giving injection ''Fancuran'' bromide 2 ml (4 mg) I.V. by the night sister mistaking it for an analgesic, the boy went into total muscular paralysis, cyanosis and Brady cardia. Of course he too thereafter described the condition of the boy and the resuscitatory measures undertaken. This letter Ex. A-11 in our opinion clinches the issue wherein not only the injection ''Fancuran'' was mentioned but also the quantity, time at which and how it was administered, by whom etc., are all clearly mentioned. It is also clearly mentioned that by mistake night sister taking it for analgesic administered this injection and the boy went into total muscular paralysis, cyanosis and Brady cardia. In view of these details, we cannot accept the contention of the opposite parties that only ''Divon'' was given by the third opposite party sister and not ''Fancuran''. Within second according to the complainant but within 5-10 minutes according to Dr. Radhakrishna the boy was discovered to be in Cardio Respiratory Arrest. From this the irresistible conclusion that has to be drawn is that the third opposite party sister negligently without verifying whether it is ''Divon'' or not administered ''Fancuran''. Therefore, there is deficiency in service on her part.

The third opposite party is an employee under the first opposite party hospital. Hence the first opposite party hospital is vicariously liable.

THE next question is whether the second opposite party is liable for the negligence committed by the third opposite party ? The second opposite party that was first consulted by the complainant for the ailment of his son. It is the second opposite party that directed the complainant to approach the first opposite party hospital through his letter Ex. A-2. Therefore, the responsibility has to be attached and the deficiency in service has to be fastened to the second opposite party doctor also, since the patient was under his care who got him admitted in the first opposite party hospital where this mishap occurred. Therefore, we are of the view that opposite party Nos. 1 to 3 are jointly and severally liable for the deficiency in service. Then what is the quantum of damages the complainant is entitled to, will be the next question ?

NO doubt the complainant claims that the boy was studying in 9th Standard in an English Medium School at Kurnool and he was a brilliant boy and the parents have got high hopes about his future. He also filed Ex. A-13 school record and other school certificates showing that the boy won prizes for elocution and was getting first rank with highest mark in some tests. Having regard to the fact that the complainant and his wife are deprived of the love and affection of their only son, we are of the opinion that a sum of Rs. 2 lakhs towards mental agony, loss of love and affection and also towards hospital charges will meet the ends of justice. Accordingly, the opposite party Nos. 1 to 3 and 5 are directed to pay a sum of Rs. 2,00,000/- with interest at 12 per cent per annum from the date of filing of the complaint i.e. 4.3.1998 till payment. The complaint against the fourth opposite party Sister Chinnamma is dismissed as no negligence is proved against her.

THE complaint is accordingly allowed in part to the extent indicated above with costs of Rs. 10,000/-. Six weeks'' time is granted for payment. Complaint partly allowed.